What is a squint?
A squint is a condition of the eyes where there is an imbalance of muscles such that the eyes do not face in the same direction. In children under the age of three, the most common squint is a convergent squint where the eyes turn together.
What causes a squint?
A squint can be caused in three ways; an imbalance of muscles, a need for glasses and a combination of both of these.
In some children there is an imbalance of muscle strength with the inside muscles (medial recti muscles) being stronger than the outside muscles (lateral recti muscles). This causes both eyes to be turned in but at any one time, your child will look straight ahead with the better of his/her eyes. If this situation continues, your child will become dependent on the eye that is looking straight ahead and the eye that is squinting (turning in) can become weaker. This has previously been called a lazy eye although I don’t like to use this term as this implies some blame or laziness on behalf of either the child or his/her parents.
If the squint cannot be managed with glasses and is either causing a functional or cosmetic problem, your child may be best to have a squint operation where the eye muscles are re-balanced.
The second reason that a child might squint is that they are long sighted and require glasses. Without glasses the child might have blurry vision and may try to make an increased effort to focus which drives the eyes together.
When your child attends for an assessment for a squint, he/she will first have a full orthoptic assessment which allows us to measure the vision in children over the age of six weeks of age. The position of the eyes will also be measured with prisms. Once this assessment has been completed, your child will have a full ophthalmological examination with Mr Simmons which will include the instillation of dilating drops. These drops allow a clear examination of the back of the eye (which is used to rule out serious pathology such as eye tumours) and also allows testing for glasses using a swinging light and a series of lenses. Once the strength of the glasses has been established and prescribed, in some children glasses alone are enough to control a squint.
The third cause for a squint in children is a combination of muscle imbalance and the need for glasses. In these cases once the glasses are prescribed, wearing them reduces the squint but does not completely abolish it.
